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  • [My good fortune is not that I've recovered from mental illness...my good fortune lies in having found my life.]

    [對我來說,真正的幸運不是心理疾病好轉,而是找到生命的真諦。]

  • [Dr. Emile Kraepelin's office, 1887.]

    [ 1887 年 Emile Kraepelin 醫生的辦公室。]

  • Schizophrenia was first identified more than a century ago, but we still don't know its exact causes.

    思覺失調症在一百多年前就被發現了,但至今它真正的病因仍是團謎。

  • It remains one of the most misunderstood and stigmatized illnesses today.

    它在現今社會中是最被誤解和汙名化的疾病之一。

  • So, let's walk through what we do know from symptoms to causes and treatments.

    接下來,我們就好好地了解它的症狀、成因和治療方法。

  • Schizophrenia is considered a syndrome, which means it may encompass a number of related disorders that have similar symptoms but varying causes.

    思覺失調症是一種症候群,換言之,它是由數個不同成因的病徵組合而成。

  • Every person with schizophrenia has slightly different symptoms.

    每位思覺失調症患者的症狀都不同。

  • And the first signs can be easy to misssubtle personality changes, irritability, or a gradual encroachment of unusual thoughts.

    而它出現的第一個病徵很容易被忽略,例如:性格上些微的改變、易怒、常常想一些奇怪的事情。

  • Patients are usually diagnosed after the onset of psychosis, which typically occurs in the late teens or early twenties for men and the late twenties or early thirties for women.

    患者通常在病徵開始顯現才會被診斷出來,好發年齡介於青春期晚期,二十初歲的男性或是約三十歲的女性。

  • A first psychotic episode can feature delusions, hallucinations, and disordered speech and behavior.

    早期的症狀有妄想、幻覺、言語表達或行為舉止異常。

  • These are called positive symptoms, meaning they occur in people with schizophrenia but not in the general population.

    這些都被稱作「正性症狀」,也就是只會出現在思覺失調症患者身上,正常人不會有的症狀。

  • It's a common misperception that people with schizophrenia have multiple personalities.

    大眾對思覺失調症還有一個誤解,那就是他們有多重人格。

  • But these symptoms indicate a disruption of thought processes, rather than the manifestation of another personality.

    但這些症狀顯示出的是思考障礙,而非有其他人格。

  • Schizophrenia also has negative symptoms.

    思覺失調症也有負性症狀。

  • These are qualities that are reduced in people with schizophrenia, such as motivation, expression of emotion, or speech.

    指的是思覺失調症患者沒有的行為,例如:生活動力、情感表達、言語表達。

  • There are cognitive symptoms as well, like difficulty concentrating, remembering information, and making decisions.

    另外,還有跟認知有關的症狀,例如:注意力無法集中、記性差、選擇障礙等。

  • So what causes the onset of psychosis?

    究竟它的病因是什麼呢?

  • There likely isn't one single cause, but a combination of genetic and environmental risk factors that contribute.

    它的病因有很多種,主要是基因和環境因素所導致。

  • Schizophrenia has some of the strongest genetic links of any psychiatric illness.

    思覺失調症跟部分精神疾病在基因上有很緊密的連結。

  • Though about 1 percent of people have schizophrenia, children or siblings of people with schizophrenia are ten-times likelier to develop the disease.

    雖然只有百分之一的機率患有思覺失調症,但患者的小孩或是兄弟姊妹有十倍的機率罹患此病。

  • And an identical twin of someone with schizophrenia has a 40 percent chance of being affected.

    雙胞胎若其中一人有思覺失調症,則另外一人有 40% 的機率受到影響。

  • Often, immediate relatives of people with schizophrenia exhibit milder versions of traits associated with the disorder, but not to an extent that requires treatment.

    通常,患者的直系親屬也會有類似的症狀,只是比較輕微,不需要接受治療。

  • Multiple genes almost certainly play a role, but we don't know how many, or which ones.

    有許多基因都跟此病有關,不過我們仍不清楚一共有多少個,或是哪一個。

  • Environmental factors like exposure to certain viruses in early infancy might increase the chance that someone will develop schizophrenia.

    至於環境因素,在嬰幼兒時期受到某種病毒的感染也會提升罹患思覺失調症的機率。

  • And use of some drugs, including marijuana, may trigger the onset of psychosis in highly susceptible individuals.

    服用毒品,好比吸食大麻也可能會增加罹患精神疾病的機會。

  • These factors don't affect everyone the same way.

    不過,每個因素在不同人身上所造成的影響也不同。

  • For those with very low genetic risk, no amount of exposure to environmental risk factors will lead them to develop schizophrenia.

    對於那些基因風險極低者,即使曝露在特定環境因素下,也不會因此引發思覺失調症。

  • For those with very high risk, moderate additional risk might tip the balance.

    但那些基因風險高的人,額外的環境因素可能就會成為是否引發思覺失調症的關鍵。

  • The antipsychotic drugs used to treat schizophrenia have helped researchers work backwards to trace signatures of the disorder in the brain.

    研究者透過思覺失調症的治療藥物來追溯觀察患者異常的大腦運作模式。

  • Traditional antipsychotics block dopamine receptors.

    傳統的精神病藥物都帶有多巴胺受體拮抗作用。

  • They can be very effective in reducing positive symptoms, which are linked to an excess of dopamine in particular brain pathways.

    正性症狀和分泌過多的多巴胺有緊密關聯。

  • But the same drugs can make negative symptoms worse.

    不過,部分精神藥物可能會讓負性症狀更嚴重。

  • And we've found that negative symptoms of schizophrenia may be tied to too little dopamine in other brain areas.

    因為研究者發現負性症狀跟大腦部分區域多巴胺分泌太少有關。

  • Some people with schizophrenia show a loss of neural tissue.

    有些思覺失調症患者的神經組織比正常人還要少。

  • And it's unclear whether this atrophy is a result of the disease itself or drug-induced suppression of signaling.

    不過,仍未有證據顯示神經組織的萎縮跟此疾病或是藥物引發的抑制現象有直接關係。

  • Fortunately, newer generations of antipsychotics aim to address some of these issues by targeting multiple neurotransmitters, like serotonin in addition to dopamine.

    值得關注的是,新的藥物不只抑制多巴胺分泌,同時也帶有其他神經傳導物質的拮抗作用,例如:血清素。

  • It's clear that no one transmitter system is responsible for all symptoms.

    沒有一個傳導系統和所有的症狀有關。

  • And because these drugs affect signaling throughout the brain and body, they can have other side effects like weight gain.

    另外,因為藥物會影響大腦和身體間的信號傳導,所以會引發副作用,例如:體重增加。

  • In spite of these complications, antipsychotics can be very effective, especially when combined with other interventions like cognitive-behavioral therapy.

    儘管有這些併發症,抗精神藥物還是非常有效,特別是和認知行為治療搭配使用。

  • Electroconvulsive therapy, though it provides relatively short-lived relief, is also reemerging as an effective treatment, especially when other options have failed.

    電痙攣療法雖然有效期短暫,但當其他方法都失敗的時候,它通常是最有效的治療方式。

  • Early intervention is also extremely important.

    最後,盡早治療是非常重要的。

  • After months or years of untreated psychosis, certain psychoses can become embedded in someone's personality.

    如果拖延數月或甚至數年不治療精神疾病,那麼精神錯亂現象將會在人格中根深柢固。

  • And yet, the dehumanizing stigma attached to this diagnosis can prevent people from seeking help.

    而社會對此疾病的錯誤負面印象會讓患者不願尋求協助。

  • People with schizophrenia are often perceived as dangerous, but are actually much more likely to be the victims of violence than the perpetrators.

    思覺失調症患者常常會被認為具有危險性,但事實上,他們比較像是社會暴力底下的受害者而非加害者。

  • And proper treatment may help reduce the likelihood of violence associated with schizophrenia.

    適當的治療可以大大減緩思覺失調症的暴力頃向。

  • That's why education for patients, their families, and their communities helps erode the stigma and improves access to treatment.

    而這也是為什麼患者和他的家人,甚至整個社會的教育非常重要,因為可以消除社會成見,進而讓患者更願意接受治療。

  • Continue to educate yourself about the symptoms, causes, and treatments of different mental health conditions with this playlist.

    更多與其他心理疾病的症狀、成因和治療方式有關的影片都在這個播放清單中。

[My good fortune is not that I've recovered from mental illness...my good fortune lies in having found my life.]

[對我來說,真正的幸運不是心理疾病好轉,而是找到生命的真諦。]

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B1 中級 中文 TED-Ed 思覺 失調症 症狀 患者 治療

什麼是精神分裂症?- Anees Bahji (What is schizophrenia? - Anees Bahji)

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    林宜悉 發佈於 2021 年 01 月 14 日
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